Provider Demographics
NPI:1619949708
Name:JOHNSON, FRANK JR (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:JOHNSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13400 N MERIDIAN ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-7102
Mailing Address - Country:US
Mailing Address - Phone:317-582-7529
Mailing Address - Fax:317-582-7602
Practice Address - Street 1:13400 N MERIDIAN ST
Practice Address - Street 2:SUITE 600
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-7102
Practice Address - Country:US
Practice Address - Phone:317-582-7529
Practice Address - Fax:317-582-7602
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01033366A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100047580AMedicaid
IN000000086360OtherBLUE CROSS BLUE SHIELD
IN795840Medicare PIN
IN100047580AMedicaid